Repositório Colecção:http://hdl.handle.net/10400.18/262015-08-02T20:25:37Z2015-08-02T20:25:37ZBacterial biofilms: a story of persistence and invasionSousa, SaraBandeira, MariaCarvalho, Patricia ALmeidaDuarte, AidaJordao, Luisahttp://hdl.handle.net/10400.18/29242015-02-20T02:00:38Z2014-09-01T00:00:00ZTítulo: Bacterial biofilms: a story of persistence and invasion
Autor: Sousa, Sara; Bandeira, Maria; Carvalho, Patricia ALmeida; Duarte, Aida; Jordao, Luisa
Resumo: Biofilms are described as colonies of microorganisms that are attached to each other and to a surface, in an irreversible mode. These structures are virtualy everywhere: natural and humanized environments, as well as within living beings (humans and animals). For a long time biofilms where regarded as a bacterial survival strategie. Nowadays, in the industrialized world, the impact of acute bacterial infections caused by rapidly proliferating planktonic cells have gradually decreased in comparison to chronic infections owing to environmental organisms growing as biofilms. The major concern in this field is the healthcare-associated infections (HAIs). In 2012, HAIs estimated cases reached 6.7 million either in long-term care facilities or acute-care hospitals from which result 37,000 deaths configuring a serious public health problem [1].
The etiological agents are diverse being often resistant to antimicrobials and able to assemble biofilms both in abiotic and biotic surfaces. Here we evaluated the ability of different bacteria to assemble biofilms on a model surface and materials mimicking surfaces present either on healthcare units or medical devices. All bacteria were able to assemble biofilmls although following different kinetics and exhibiting different structural features assessed by electron microscopy. Additionally a link was established between bacteria ability to assemble biofilms and increased antibiotic resistance [2].
1. ECDC Europe; (2012), Annual epidemiological report 2011
2. Bandeira M; (2014), Pathogens (doi:10.3390/pathogens3030720)2014-09-01T00:00:00ZSurveillance in the time of austerity; Portuguese HIV/AIDS Surveillance achieves a 30% improvement in efficiency after LEAN inspired changes to processingShivaji, TaraCortes Martins, HelenaDiniz, AntonioNogueira, Paulo JVasconcelos, PaulaSilva, Andreiahttp://hdl.handle.net/10400.18/29022015-02-19T14:48:54Z2014-11-05T00:00:00ZTítulo: Surveillance in the time of austerity; Portuguese HIV/AIDS Surveillance achieves a 30% improvement in efficiency after LEAN inspired changes to processing
Autor: Shivaji, Tara; Cortes Martins, Helena; Diniz, Antonio; Nogueira, Paulo J; Vasconcelos, Paula; Silva, Andreia
Resumo: Background
In 2013, following reminders about statutory notification of HIV/AIDS, Portuguese clinicians notified all cases, irrespective of previous notification. At the same time, hospitals introduced electronic records that automatically generated additional paper notification reports. No supplemental resources were available to process the 10-fold increase in notifications. The ensuing backlog caused delays in providing timely information for HIV program planning and evaluation. We investigated whether management principles from the automobile industry (LEAN) could improve data management efficiency.
Methods
Efficiency was defined as the time spent processing the paper report into electronic surveillance information. We used value stream mapping to understand the process and employed focus groups to identify areas for improvement (LEAN methodology). We recorded the time taken to complete this process for randomly selected batches of reports and calculated the average time per report.
Results
When consulted, stakeholders expressed the need for information about recent HIV/AIDS diagnoses. We prioritized processing cases diagnosed between 2011-2013. We reduced data-entry errors and transcribing time by inserting drop-down menus and automatic variable calculators. We implemented auto-search during data entry to prevent duplication. We redesigned the data entry mask to match the paper report. Before intervention, processing time was 9 minutes and 28 seconds (95%CI 8:53-10:58) per report. Two months post-intervention, this was 6 minutes and 34 seconds (95% CI 6:25-6:43), reducing the time to process the remaining backlog (10,000 reports) by 54 days.
Conclusion
Applying LEAN techniques to HIV/AIDS surveillance in Portugal enabled delivery of crucial information to national and international HIV stakeholders through a 30% reduction in data processing time and optimization of data quality. Public health practitioners should consider LEAN techniques to improve data quality and efficiency of surveillance systems.2014-11-05T00:00:00ZMonitoring influenza vaccine effectiveness using the national influenza surveillance systemMachado, AusendaFreitas, Maria GraçaGuiomar, RaquelDias, Carlos MatiasNunes, Baltazarhttp://hdl.handle.net/10400.18/25782015-01-07T02:00:15Z2014-11-01T00:00:00ZTítulo: Monitoring influenza vaccine effectiveness using the national influenza surveillance system
Autor: Machado, Ausenda; Freitas, Maria Graça; Guiomar, Raquel; Dias, Carlos Matias; Nunes, Baltazar
Resumo: Background: Due to the annual reformulation of the influenza vaccine composition estimates of the vaccine effectiveness (VE) are required every season. A portuguese influenza surveillance system is in place, and data obtained by this system may be used to evaluate VE (compared to studies specifically designed to this purpose). This study intends to evaluate the feasibility of using the national influenza surveillance system for monitoring the influenza VE (MonitorEVA).
Methods: Two different study designs were implemented to estimate VE in season 2004-05 to 2011-12: Test negative design (TND) and screening method (SM). TND used a case-control approach where laboratory confirmed incident influenza like illness patients (ILI+) were compared to laboratory negative influenza ILI patients (ILI). Eligible individuals to this study consisted on individuals from all ages that consult a general practitioner or the emergency room (ER) with ILI symptoms. VE was estimated as 1-odds ratio of being vaccinated in cases versus controls adjusted for age and month of onset by logistic regression.
For the SM, VE was estimated by comparing the proportion of vaccinated cases (recruited within TND) to the vaccine coverage in
the source population (obtained from a sample of households, using a telephonic survey - ECOS sample), using the Orenstein formula
and the Farrington method to adjust for age group.
Results: Considering TND, crude point estimates of VE were under 40% in 2004/05, 2005/06 and 2011/12 season; between 50% and 70% in 2006/07, 2008/09 and 2010/11 seasons, and above 70% in the 2007/08 season. After adjustment for age group and month of
onset, the VE point estimates decreased.
SM estimates were in accordance to the TND ones but for the majority of the SM VE was lower than the TND.
Discussion/Conclusions: Sample size and data quality are sufficient to obtain crude VE estimates with statistical significance (if VE is higher than 50%), however allowing less precise estimates. The surveillance data allowed the VE monitoring indicating if the VE was higher than 70% and less than 50%. Improvement of data quality in the surveillance program seems a potential way of improving precision and closing the gap between the two methods proposed.2014-11-01T00:00:00ZGenetic variation at the IFITM3 and Influenza A(H1N1)pdm09 infection severity in the Portuguese populationGaio, VâniaNunes, BaltazarPechirra, PedroConde, PatríciaGuiomar, RaquelMatias Dias, CarlosSilva, Marta Barreto dahttp://hdl.handle.net/10400.18/24022014-10-31T02:00:42Z2014-09-10T00:00:00ZTítulo: Genetic variation at the IFITM3 and Influenza A(H1N1)pdm09 infection severity in the Portuguese population
Autor: Gaio, Vânia; Nunes, Baltazar; Pechirra, Pedro; Conde, Patrícia; Guiomar, Raquel; Matias Dias, Carlos; Silva, Marta Barreto da
Resumo: Interferon-inducible transmembrane protein (IFITM3) inhibits the entry of viruses to the host cell, mediating resistance to influenza infection. It has been demonstrated that a genetic variation in the IFITM3 gene (rs12252) alters a splice-site, originating a protein with reduced activity. In this context, our aim was to determine if the C allele of the IFITM3 rs12252 polymorphism is associated with influenza infection or hospitalizations related to Influenza A(H1)pdm09 in the Portuguese population.
To achieve our goal, a case-control study design was developed using the nasal swabs collected during the 2009 pandemic, on the context of the National Influenza Surveillance Program. Non-hospitalized influenza cases were defined as patients with influenza like illness (ILI) who tested positive for influenza A(H1)pdm09 and did not require hospitalization. Hospitalized-influenza cases were defined as ILI patients who tested positive for A(H1)pdm09 infection and who were hospitalized. For these cases groups two types of controls were selected: non-hospitalized ILI cases negative for A(H1)pdm09 and hospitalized ILI patients negative for A(H1)pdm09 infection. We have therefore selected 212 non-hospitalized influenza cases, 96 hospitalized influenza cases, 403 non-hospitalized negative controls and 198 hospitalized negative controls.
We found that hospitalized negative controls had the highest frequency of allele C carriers (22.5%) and the lowest frequency was found among the non-hospitalized negative controls (11.11%). No association was found between testing positive for A(H1)pdm09 infection (susceptibility to infection) and the C allele of rs12252. We have also found that the risk of being hospitalized (independently of infection status) for the allele C carriers is the highest, after adjustment for age and gender, (OR: 1.59 (95% CI: 1.05-2.43). Our results suggest that the allele C of the IFITM3 rs122252 polymorphism was associated with respiratory disease hospitalizations but not specifically associated with the infection by Influenza A(H1N1)pdm09.2014-09-10T00:00:00Z